This story is not meant to serve as medical advice and is for informational purposes only.

Women around the country celebrated when the first over-the-counter birth control pill, Opill, was approved by the Food and Drug Administration. But despite the fact that an important medication that was once gatekept has been available to everyone for nearly a year, Opill hasn't really caught on.

A 2024 KFF survey found that just 26 percent of women between the ages of 18 and 49 have even heard of Opill, and only 3 percent have actually used it. Even worse, people who could benefit the most from Opill — those without health insurance and who live in contraceptive deserts — are less likely to know about this medication.

Opill is relatively inexpensive (currently $16 at Amazon for a one-month supply) and it doesn't require a trip to the doctor. So, why aren't more women using it? We spoke to ob-gyns and real Opill users for more.

Experts Featured in This Article:

Jessica Shepherd, MD, is an ob-gyn in Texas.

Christine Greves, MD, is an ob-gyn at the Winnie Palmer Hospital for Women and Babies in Orlando, Florida.

Adi Katz, MD, is the director of gynecology at Northwell Lenox Hill Hospital.

Mary Jane Minkin, MD, is a clinical professor of obstetrics and gynecology and reproductive sciences at Yale School of Medicine.

Jamie Alan, PhD, is an associate professor of pharmacology and toxicology at Michigan State University.

The Education Gap Is Real.

As the KFF survey shows, plenty of women aren't aware that OTC birth control is available to them. "There is an education gap when it comes to its availability, its use, and its mechanism of action," says Jessica Shepherd, MD, an ob-gyn in Texas. "There clearly needs to be more time spent with educating consumers, as well as for the medical community to put this into the profile of contraceptive options when counseling patients."

Opill hasn't been out there for that long, points out Christine Greves, MD, an ob-gyn at the Winnie Palmer Hospital for Women and Babies in Orlando, Florida. (It was FDA-approved in 2023, and started hitting shelves in March 2024.) "Birth control pills are typically prescribed for a year," she says. With that, people may want to stick with what they know is working before exploring something else, she says.

Fear around switching to something new and it not being as effective has also caused some concern. Opill user Katherine* says she was initially nervous to try Opill for that reason. "My main hesitation was that since it wasn't prescribed by a doctor, that maybe its safety or efficacy would be affected," she says. "However, I did extensive research before starting."

Adi Katz, MD, director of gynecology at Northwell Lenox Hill Hospital, has heard similar concerns. "Many people are still learning about it," she says. "Some women may not feel confident choosing a birth control method without talking to a doctor."

While Opill has been out for a year, birth control isn't something that people discuss a lot. That makes it harder for word of mouth buzz to spread around the medication, Dr. Shepherd points out.

Some people also seem to be unsure of what Opill actually is. "There is the misconception that possibly this is not a contraceptive and maybe more similar to Plan B," Dr. Shepherd says.

Here's What to Know About Opill:

Opill is a progestin-only birth control pill, similar to medication that's already available by prescription, says Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale School of Medicine. "Basically the Opill is the same as the prescription medication Ovrette," she says. "Both have norgestrel, which is a synthetic progestin in the same dosage—0.075 milligrams."

That said, progestin pills like Opill, hich are often called the "mini pill," require more careful use to be effective, says Jamie Alan, PhD, an associate professor of pharmacology and toxicology at Michigan State University.

"You need to take the pill at very close to the exact time every day for it to be effective," she says. "You have to take it within the same three-hour period daily." If Opill isn't taken within the same window, it's less likely to be effective, raising the risk of an unintended pregnancy, Dr. Alan says.

"It is effective if you take it as intended," Dr. Alan explains. "But it is harder to take as intended because of the timing."

Women Have Had Mixed Experiences.

Women we spoke with who have tried OTC birth control have had different results. Katherine says she first heard about the birth control from commercials on TikTok and from spotting it at her local Walmart. At the time, she was frustrated by an experience with a doctor who tried to pressure her into getting an IUD.

"I liked that you didn't have to see a doctor to get Opill," she says. "I also like the convenience of it. If I forget my current pack at home, I can just run to any Walmart, CVS, etc. and grab a new pack with no worries. The accessibility is incredible."

Katherine says her experience with Opill has been "extremely positive," although she noticed she had some abdominal cramping and periods that were more uncomfortable than usual at first. "The only side effect that I currently experience is that I sometimes get headaches and brain fog, but [it's] nothing I can't handle," she says.

But Tatianna* had a slightly different experience on Opill. She says she was "super relieved" when she first discovered the medication, given that her local pharmacy would sometimes take a while to fill her prescription birth control. "At first it was great. It even helped control my acne," she says. "But then after a while, I started experiencing a lot of bleeding randomly...it was not worth the convenience if I was still having the paranoia of bleeding through my clothes." (Opill states on its website that users may notice changes in their period, including heavier or lighter bleeding than usual.)

"The only good thing it did was help me manage my acne and prevent unwanted pregnancy," Tatianna says. "I've since switched back to a doctor-prescribed birth control and am having a way better experience."

Editor's note: PS reached out to Opill for comment and did not hear back before publishing.

Here's What to Know About Potential Side Effects:

Every medication has side effects and every body is different. Common side effects of Opill, according to the Food and Drug Administration (FDA) include, irregular vaginal bleeding, nausea, breast tenderness, and headaches. But these symptoms are said to be mild and resolve on their own. If you are experiencing more severe or long-lasting changes to your cycle, body, and quality of life after switching to any new medication — including OTC birth control — you should reach out to a healthcare provider.

Switching to OTC Birth Control Could Be More Costly.

Yes, Opill is inexpensive and easy to get. But for women who have health insurance coverage, prescription birth control is often free, Dr. Minkin says. "Many women can get oral contraceptive prescriptions at no cost if they are seeing a regular prescriber, or get them with a prescription at a discount, if they have to pay anything," she points out. However, Opill is often a cheaper alternative for women without health insurance than seeing a doctor and paying out of pocket for a prescription.

The Bottom Line:

There is a wide variety of birth control options available to women, and that can make finding the right one tough. "Picking the right pill is like picking the right partner," Dr. Greves says. "Sometimes people don't want to try something new because what they have may be working." And that's OK.

But if you're looking for another birth control option, Opill may still be a good contender. "OTC birth control is likely to become more popular as awareness grows," Dr. Katz says. "It provides an easy, accessible option for people who might not have regular access to healthcare or a prescription."

Some people, like Katherine, also like the medication. She points out that she's been on Opill for almost a year, and she plans to continue to use it until she's ready to start a family. "It has proven itself to work," she says. "For now, this is the perfect solution."

In other words, when it comes to finding the right birth control option — whether it's Opill or not — the best option is the one that works best for you.

*To protect the identity of our sources, we have only used their first names.